Objective To observe the effect of a combination therapy of three blood purification methods on acute hydrogen arsenide poisoning.
Methods Twenty patients with acute hydrogen arsenide poisoning were recruited from The First Affiliated Hospital of Kunming Medical University from 2002 to 2011, and received a combination of plasma exchange (PE), hemoperfusion (HP), and continuous veno-venous hemofiltration (CVVH) after basic treatment. The clinical manifestations and laboratory indicators were observed before and after the combined treatment.
Results All the 20 patients with acute hydrogen arsenide poisoning appeared symptoms of chills, fever, headache, fatigue, lumbar back pain, scleral skin yellowing, anemia, and varying degrees of hemoglobinuria before admission. Above symptoms were alleviated to disappear after the combined treatment for 4-12 days. Hemoglobin (104.0 g/L) was decreased on admission, while alanine aminotransferase (104.1 U/L), aspartate aminotransferase (101.5 U/L), creatine kinase (251.5 U/L), lactate dehydrogenase (1 802.5 U/L), total bilirubin (96.0 μmol/L), non-binding bilirubin (82.5 μmol/L), bilirubin (13.1 μmol/L), creatinine (168.7 μmol/L), and urea nitrogen (13.3 mmol/L) were increased. Total bilirubin (29.1 μmol/L) and non-binding bilirubin (16.3 μmol/L) were decreased obviously after 3 days of treatment. Red blood cells and hemoglobin were lower than the lower limit of normal, and alanine aminotransferase and creatinine were higher than the upper limit of normal after 10 days of treatment. Total bilirubin, non-binding bilirubin, aspartate aminotransferase, creatine kinase, lactate dehydrogenase, and urea nitrogen returned to normal after 10 days of treatment. The arsenic concentrations in dialysate and urine returned to normal after 3 days of treatment. All laboratory indicators returned to normal after the follow-up 6 weeks.
Conclusion The combination of PE, HP, and CVVH is effective for the treatment of acute hydrogen arsenide poisoning.
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